SALT LAKE CITY (News4Utah) – After battling over Medicaid expansion for years, the state legislature came to an agreement this year.

House Bill 472 would provide health insurance for tens of thousands of Utahns who currently go without, but opponents question whether the state can deliver on that promise.

An estimated 65,000 people in our state fall into the Medicaid coverage gap. Their plight has been the center of debate at the State Capitol for years.

After a few failed attempts in previous years, Representative Robert Spendlove got his Medicaid expansion bill through the legislature.

"On the extreme right they said we shouldn't do anything. On the extreme left they said we should do everything. But, the middle, where people really come to consensus there was strong support," said Spendlove, (R) Dist. 49.

HB 472 expands Medicaid to 100% of the federal poverty level. It includes a 90/10 split with the federal government, requires participants to work and has cost control caps.

Spendlove says it will cover an estimated 90,000 Utahns by the 6th year.

A plan like this has yet to get the green light from the feds. That's why opponents are weary.

"CMS doesn't really have the legal authority under the law to grant such a thing, which is why it's never been done before, and why we don't expect it to happen with this waiver," said Stacy Stanford with Utah Health Policy Project.

Stanford has been in the coverage gap. She says the Utah Decides Healthcare ballot initiative is the only sure solution.

"The ballot initiative fully closes the gap, no strings attached and it doesn't rely on approval from the federal government," she said.

Spendlove says the federal government has approached the state and offered good indications it will sign off.

He says the legislative approach is the more responsible way forward.

"House Bill 472 requires no new state money to administer. The ballot initiative has a tax increase to fund the program," he said.

Governor Herbert is expected to sign the bill, but if the ballot initiative does pass, it will override it.

If the ballot initiative fails and the bill moves forward, the earliest it would be implemented is July, 2019.